Purpose To determine the efficacy of safe surgery system trabeculectomy combined with manual small incision cataract surgery/ phacoemulsification in primary glaucoma coexistent with cataract. Methods This is a retrospective analysis of 105 cases who underwent single-site combined surgery between January 2008 and December 2009. Safe surgery system trabeculectomy with diffuse and posterior application of mitomycin C was performed in all cases. Cataract extraction was done either by Manual Small Incision Cataract Surgery (MSICS) or phacoemulsification. Main outcome measures were success rate of trabeculectomy, as determined by four different IOP goals and incidence of postoperative complications. Analysis was performed using R-2.15, and the significance was tested at 5% level. Results The minimum follow-up period was 12 months. The overall success rates (with or without medication) when safe surgery system trabeculectomy was combined with MSICS were 91, 70, and 51% for IOP r18, r15, and r12 mm Hg, respectively, and target IOP was achieved in 72% cases. The mean IOP reduction was 43.8% with MSICS and 42.08% with phacoemulsification. The surgical outcome was not significantly different for both techniques. Postoperative complications were infrequent and comparable. Conclusion The Safe Surgery System Trabeculectomy combined with cataract surgery offers excellent IOP control with minimal postoperative complications. It offers an effective and improved solution for primary glaucoma coexistent with cataract found in developing countries.
Purpose:
To compare the efficacy of 0.2 mg/ml Mitomycin C (MMC) applied for 1-minute versus 2-minutes in patients undergoing combined surgery for primary glaucoma coexistent with cataract.
Materials and methods:
This was a randomized controlled clinical trial of 63 patients operated on for primary glaucoma (POAG or PACG) with visually significant cataract. All patients underwent safe surgery system trabeculectomy with manual small incision cataract surgery (MSIC) and implantation of PC IOL. Patients were randomized into intra-operative MMC 0.2 mg/ml for 1-minute (study group) and MMC 0.2 mg/ml for 2-minutes (control group). Success was measured on the basis of two different intraocular pressure (IOP) goals (IOP ≤21 mmHg, IOP ≤18 mmHg) and mean IOP reduction from baseline at the end of 12 months.
Results
: At 12 months, significant decreases in mean IOP were observed in both groups (
P
<0.001).The mean IOP reduction was 31.33±9.06% in the study group, as compared to 43.32±9.38% in the control group (
P
<0.001). The overall success for IOP ≤21 mm Hg was 80.5% in the study group and 90.9% in the control group (
P
<0.05). Kaplan-Meier analysis showed an insignificant difference in overall success rates of the two groups.
Conclusion:
The IOP reduction with 2-minute MMC (0.2 mg/ml) is more effective than 1-minute MMC after 12 months. It offers a decrease in anti-glaucoma medications and substantial visual recovery in combined surgery done for primary glaucoma coexistent with cataract.
Background: Younger generation has been getting habituated to areca nut and its products are easily available in attractive pouches, i.e., sweet supari, ghutka, kharra, etc. Tobacco and its products, being cheap and convenient to carry, have become popular in school children, resulting in various alteration of oral mucosa, one of them being oral submucous fibrosis (OSMF).
Aim:To assess the prevalence of OSMF in children of rural areas of Nagpur, Maharashtra (India).
Materials and methods:Cross-sectional survey was carried out among 8-to 17-year-old school children in rural areas of Nagpur, Maharashtra. Thorough oral examination was carried out for recording oral changes related to OSMF, with questions regarding use of tobacco and its products. The data thus collected was subjected to statistical analysis.
Results:Examination was carried out in 2,132 children; 7.3% children were found with the habit of chewing areca nut products, i.e., sweet supari, kharra, gutka, etc., and 2.9% children were found with OSMF.
Conclusion:Onset of disease is seen early because of use of areca nut at an early age. Lack of awareness in rural areas, deficient oral health program, and areca nut chewing being the most common factors for OSMF.
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